Ishida JH, et al. - In this cohort study including 140,899 Medicare-covered adults receiving hemodialysis in 2011, researchers assessed the link between opioid use (modeled as a time-varying exposure and expressed in standardized oral morphine equivalents) and time to first emergency room visit or hospitalization for altered mental status, fall, and fracture, using the US Renal Data System. Risk assessment was done according to average daily total opioid dose (>60 mg, ≤60 mg, and per 60-mg dose increment) and specific agents (per 60-mg dose increment). In patients on hemodialysis, opioids were found to be related to adverse outcomes. The presence of this risk was noted even at lower dosing and for agents that guidelines have recommended for use.